War of the Womb: North Dakota is the new abortion battleground.

In Manitoba, the fight has never faded away

FARGO, N.D.: In the 1970s and 1980s, Winnipeg women seeking safe and legal abortions often travelled to North Dakota for the procedure. An underground railroad system was in place, transporting pregnant women across the border.

There were two state physicians known to offer abortions in their offices and, rather than go through questioning by a panel of doctors to determine if their physical or mental well-being was threatened by the pregnancy (a requirement before an abortion could be performed at a Manitoba hospital) some women headed south.

NEWSCOM

KEN GIGLIOTTI/ WINNIPEG FREE PRESS

It was a tense and emotional time when Henry Morgentaler opened his clinic in Winnipeg in 1983. For Dr. Suzanne Newman, it set her on a new direction in life. Photo Store

KEN GIGLIOTTI / WINNIPEG FREE PRESS

The Fargo clinic is the only place in North Dakota for abortions. Photo Store

TREVOR HAGAN / WINNIPEG FREE PRESS

Valerie Wadephul on North Dakota's laws: 'It's a great start for women to be free of being exploited.' Photo Store

TREVOR HAGAN / WINNIPEG FREE PRESS

Elizabeth Andrzejczak is one of hundreds who attended the March for Life rally. For her, all life is sacred. Photo Store

Tammi Kromenaker, director of the Fargo clinic, says she's not going down without a fight. Photo Store

That trend diminished with the 1983 opening, although at the time illegal, of Dr. Henry Morgentaler’s Corydon Avenue clinic. When abortion became legal and funded at free-standing clinics in 2004, there was no longer a need to leave the country.

The historic flow of women going to North Dakota for abortions may soon reverse. The state recently introduced the most repressive abortion legislation in the United States, banning abortion after six weeks or when a fetal heartbeat can be heard. That’s earlier than many women know they’re pregnant. There are no exceptions for rape or incest.

In April, American president Barack Obama said "an assault on women's rights" is underway, with bills introduced in more than 40 states to limit or ban abortion or restrict access to birth control or other services.

The bills are signed but don't go into effect until Aug. 1.

Tammi Kromenaker, director of Fargo's Red River Women's Clinic, says it's a perfect storm. North Dakota has a budget surplus due to the oil boom in the state's northwest corner, so they have the money for a legal battle. Legislators are worried about their jobs. Personhood USA, a powerful Christian anti-abortion organization, has threatened to target politicians who fight the new laws.

The Fargo clinic, which opened in 1988, is the only place in North Dakota a woman can legally have her pregnancy terminated. Kromenaker, 41, says they're not going down without a fight.

The clinic has received legal defence donations from supporters, enough to pay the cost of a local attorney for two years. The United States Centre for Reproductive Rights is paying the majority of the costs.

There were 1,333 abortions performed at the Fargo clinic in 2012. Almost half the patients were between the ages of 18 and 24. Nine per cent were over 35. They saw 58 minors, who have to notify both biological parents or have a judicial ruling before they can have an abortion. That's difficult for teens in foster case or for girls whose parents are estranged.

Kromenaker said the demand for services was obvious from the start.

"When we first opened, the very first day, three women came in. One was too far along so we had to turn her away. We completed two procedures that day."

There are about 25 abortions a week performed at the clinic. State law demands every woman have an ultrasound before an abortion. Kromenaker says about 35 per cent of the women choose to look at the ultrasound.

"For some people it's curiosity," she says. "When they see they're seven weeks pregnant and there's nothing there it can be a relief."

There are sometimes tears.

"Just because something is difficult or hard doesn't make it wrong," says Kromenaker.

Patient fees keep the doors open. A medication abortion is $550 (see box), as is a vacuum aspiration up to 11 weeks. The cost of the vacuum aspiration increases with the length of the pregnancy, topping out at $850 at 15 weeks.

There were protests and fire-bombings at an earlier Fargo abortion clinic, where Kromenaker also worked. The owner had death threats. The Red River Clinic has biometric keys, using fingerprints for entry. Security cameras tape the sidewalk activity at the clinic. There are between five to 25 protesters every Wednesday. Kromenaker trained a cadre of patient escorts to protect women entering the clinic. The sidewalk is where the battle line has been drawn. And the fight over the sanctity of life is one that can dirty, mean and ugly.

"I got a call recently from a woman," she says, "who said she was pleased with how we'd treated her 'but when I walked by the woman who said 'let me adopt your baby, you bitch', that was hard'."

"I come to work and people I don't know say, 'Hiiii, Tammi'. If I worked at Walgreens and strangers came up to me in the parking lot and called me by name, I'd call the police. It's an attempt to intimidate us."

And like any war, truth is often the first casualty. She says the posters of aborted fetuses carried by protesters look like they were full-term babies delivered with forceps in a botched birth. "I don't know where they get them, but they're all the same pictures carried at every protest."

The clinic where the abortion are performed was a real estate office on the second floor and restaurant on the main level. Skylights brighten the public areas. The ORs have flower-painted panels over the ceiling lights, an attempt to prettify the rooms for patients.

The word "relax" is spelled out in glitter letters on the side of an ultrasound machine. The radio is set to an easy-listening station.

The recovery room has recliner chairs and heating pads for women who need them. Journals are provided for women to share their post-abortion thoughts if they wish.

"I'm thankful I'm here with such supportive people and I'm blessed to have the support of my sister," one woman wrote.

"I feel very nervous to get this done," reads another. "I have a 12-month-old baby. This is the first time for me ever doing something like this but it is the best thing for me. All I gotta do is stay strong and think positive. I pray that God forgives me for my decision."

^^^^

Valerie Wadephul is a walking advertisement for her pro-life beliefs.

The 69-year-old Winnipeg woman has two 'What Would Jesus Do' pins attached to her suit jacket. She wears another shaped like a lighthouse, a reference, she says, "to Christ's light being the light of truth." She has a Catholic Women's League insignia and two small sets of bronze baby feet pins on her lapels.

The director of Life's Vision Winnipeg wears a crucifix around her neck. Her greying hair is pulled back in a ponytail. She speaks only for her pro-life affiliate and not for Life’s Vision Manitoba (formerly League for Life Manitoba).

Wadephul is a devout Catholic. She walks in front of the HSC Women's Pavilion, carrying gruesome photos of aborted fetuses to protest the hospital's policy of providing pregnancy terminations. She is frontline and in-your-face when she decides it's necessary.

Hers is a God-given calling, she believes.

"It (the hospital protests) is just something that needs to be done. Some people are scared to stand there and hold up a sign."

She says the turnouts for "life chains", the organized protests, is "pitiful".

"A lot of people don't like being there in public," she says. "We have to just smile at the people who give you the finger when they drive by. They'll come by and shout obscenities. They usually get rowdy and loud but we try to show respect to people."

When Wadephul was young, she says, it never occurred to her that abortion rights would be enshrined in law. She says abortion was "almost safer" when it was illegal.

"When abortion was illegal doctors wouldn't do it. But if a woman said 'I'm desperate, I'll try to abort myself" the doctor would sometimes say 'OK'. Now that it's legal, it's lackadaisical. They don't have the rules and regulations. They're not being inspected."

(A WRHA says the Women's Health Program is accredited by Accreditation Canada. The WHC is accredited by both the College of Physicians and Surgeons of Manitoba as well as the National Abortion Federation. Both are subject to provincial standards and inspections. Abortions are performed in Manitoba up to 20 weeks gestation. There is no limit under the Criminal Code of Canada.)

Wadephul is opposed to abortion under every circumstance.

"With today's medicine, if you speak to a doctor with integrity, he will tell you there is no reason to resort to abortion for a woman's health. Our philosophy is you try to save them both. In this day and age with medicine there's no need for abortion."

But what of women who are raped or the victims of incest? "It's wrong under any circumstances."

She calls abortion providers "the industry" and says they're only in it for the money. She says women are tricked into having abortions by unscrupulous men and "post-abortive" women never recover from their decision.

"Women are talked into being promiscuous by men who have hormones. If their pill fails, if they get her pregnant and they don't want a baby or (to) get married, they say 'get an abortion'."

(Women seeking abortions in Manitoba are interviewed alone to ensure they aren't being coerced.)

"I personally believe the person who was supposed to cure cancer was aborted a long time ago."

Wadephul says the restrictions on abortion in North Dakota are terrific.

"I think it's a great start for women really to be free of being exploited."

She believes the liberal media refuse to give voice to the pro-life cause, pointing to the case of Philadelphia doctor Kermit Gosnell, found guilty of three counts of first-degree murder in May after he botched several abortions. Babies were born alive and Gosnell snipped their necks. He is serving life in prison. Wadephul argues the outside world knew nothing of the trial until anti-abortion activists pushed for media coverage.

"They don't want us to know this is how it works, that doctors are killing babies after they're born."

The day after the interview, the Winnipeg March for Life is held. Wadephul is one of hundreds of people gathered at The Forks.

Trish Schellenberg, her husband Kevin and their two preteen children wait in the warm sun.

"We're here to be a voice for the unborn," she says. "We want to make people aware of what's going on in Canada. A person's a person, no matter what."

Her seven-year-old son wears a T-shirt emblazoned with his ultrasound images.

"There's no time a human being becomes a human being," his mother says. "It happens at conception."

People hold signs that read: 'Women Do Regret Abortion' and 'Men Regret Lost Fatherhood.' Organizers sell $20 T-shirts with the slogan 'I Speak For Those Who Can't.'

"I'm doing this because I really believe all life is sacred," she says.

After an opening prayer, several hundred people march down Broadway to the Legislative Building. There are at least twice as many people as were present at an anti-PST increase rally days earlier.

There's no media coverage of the march that night or the next day.

^^^^^

Dr. Suzanne Newman was an accidental pro-choice activist. She lived in the Corydon area where Dr. Henry Morgentaler opened his abortion clinic in the early 1980s. The stay-at-home mother was out for a walk with two of her kids when she saw protesters shouting and blocking the entrance to the clinic.

"I went over to tell them they shouldn't be doing this," recalls Newman, 66. "We saw the craziness at the clinic. People with distorted faces, those awful signs. I started shouting back at the protesters. I was a mother of four and a woman and what they were doing was wrong."

Clinic nurses pulled Newman and her children inside, fearing the confrontation would become physical.

She became a volunteer, eventually applying to medical school in 1988. She was jailed three times for her work at the clinic. Police raided and seized the clinic's equipment. The clinic eventually stopped doing abortions.

She put pregnant women in her car and drove them to North Dakota.

Newman and a group of other women bought the Corydon clinic from Morgentaler. Abortion was legalized in free-standing clinics soon after.

Lori Johnson, executive director of Klinic, ran the Morgentaler clinic in the early days.

"I was directing that clinic during some of the worst anti-choice violence," she said recently.

In 1998, New York abortion doctor Dr. Barnett Slepian was shot and killed in his home. A year earlier, Winnipeg doctor Jack Fainman was shot in a similar attack. In 1993, Dr. David Gunn of Pensacola, Fla.,was fatally shot during a protest. On May 31, 2009, Dr. George Tiller was shot and killed at church in Wichita, Kan.

In 1992, a firebomb destroyed Morgentaler's Montreal clinic.

In 1994, doctor Garson Romalis was shot at his home in Vancouver. In July 2000, he was stabbed outside his medical office.

"It was a very violent time," says Johnson.

Her young children were approached and photographed at a playground. The photographs appeared on anti-abortion literature. "I feared for my family," she says.

Joan Dawkins, executive director of the WHC, says abortion is still not consistently available here.

"If you're a young woman in Northern Manitoba, good luck to you. If your community's not supportive or your family's not supportive or transportation's an issue, it can be very difficult. You have to be able to get to a facility where abortions are performed."

Newman believes the changes to American abortion laws are an attempt to make abortion disappear.

"That will never happen," says the doctor. "There will always need to be a place for abortion, sadly."

Newman offers a tour of the WHC facility. There are cameras and visitors must be buzzed in. The WHC clinic is spit-and-polish clean. The recovery room has comfy recliners and boxes of Kleenex. She says the abortions are generally done in under 10 minutes.

"It's very quick," she says. "The hardest part is the decision."

She says most women aren't anxious before the procedure.

"Most women go through a lot of thought before they come in. Their anxiety is mostly about whether or not there will be pain."

An IV is inserted before the abortion starts. Patients can have a Valium-like drug and a painkiller.

If a woman is less than nine weeks pregnant she'll have a manual vacuum aspiration.

"I love it because it's easy, it's simple," she says. After nine weeks a suction machine is used.

She says she will not perform an abortion if a woman is wavering. She concedes "nobody likes abortion."

Indeed, in the freighted language around abortion, no one uses "pro-abortion." They prefer "pro-choice" or "in favour of a woman's right to reproductive choice." Those who oppose abortion prefer "pro-life" to "anti-abortion."

^^^^^

When the battle lines were drawn in Winnipeg in the '80s, there were two clear camps. On one side was Henry Morgentaler and his supporters. On the other were people like the late Pat Soenen, head of the Manitoba League For Life.

In an email after Morgentaler died late last month, lawyer Rocky Kravetsky, who worked with Greg Brodsky to defend the doctor in Winnipeg, discussed the relationship between the pair.

"She was in some ways Henry's exact opposite, in others not that different from him at all," Kravetsky wrote. "She was opposite in her position on the abortion issue and also in her public persona, to the extent she had one. She didn't seek out publicity but when it came she spoke honestly, clearly and reasonably.

"When court judgments went against her and her cause she led her organization to focus more of its efforts on preventing unwanted pregnancies and on public information. Like Henry, she respected the process and the rule of law. In a debate that was too often reduced to people screaming slogans at each other she made her points calmly, with reason and respect. She never, never attacked the women who sought out abortions. She and Henry agreed that unwanted pregnancies should be prevented. She reached out to women faced with unwanted pregnancies and helped to establish the Pregnancy Distress Service. She understood choice and wanted to provide one...

"Abortion is a tough issue. For those who face the decision it engages the very question of what makes a person. On the legal level it engages also questions of the rights and freedoms. Those who champion one side or another (and there are more than just two sides) are often too overcome by the confidence of their faith in the right of their point of view to allow them to hear another opinion. Worse, as happens with many issues, they lose sight of the humanity of their opponents. Slap a label on someone and they are reduced to that. Henry Morgentaler and Pat Soenen were on opposite sides of this issue at a moment in time, but neither ever lost respect for those who made different choices or held different views. I never heard one say a bad thing about the other."

Mike Soenen agrees with Kravetsky's appraisal of his mother, who died in 1999.

He remembers listening to his mother practice late-night speeches. He remembers how she sacrificed to be the public face of the pro-life movement.

"My mom was Roman Catholic. Mom just felt it (the abortion issue) required her attention. She felt compelled... She basically devoted her entire married life to this."

He and his siblings are all pro-life, but he's never been as committed as his mom.

"I don't think standing in front of an abortion clinic and yelling at her is the way. I think you can pray. I would never subscribe to berating someone in that way."

He agrees that his mother had a certain respect for Henry Morgentaler.

"The thing that she said was he was committed to his cause. He believed he was doing good for the benefit of women."

If a woman is less than nine weeks pregnant, she can choose a medication or surgical abortion. If she chooses medication, she takes a pill in the presence of the clinic doctor. It blocks the hormone a woman needs to remain pregnant. Between 24 to 48 hours later, she takes a second medication "which starts the miscarriage-like process, where you pass the pregnancy at home," says Tammi Kromenaker, director of Fargo's Red River Women's Clinic.

If a woman is more than nine weeks pregnant, she has a surgical abortion. She meets with a patient educator, who ensures she understands the procedure and is freely choosing to have the termination. She then meets the doctor.

"We're working with your body on things it already knows how to do," says Kromenaker. "Your cervix opens up every month to allow the menstrual blood to pass through and if you carry a pregnancy to term it opens all the way up. What we're going to do is numb your cervix. We use a local anesthesia called Lidocaine. It's the same thing that's used in your mouth at the dentist. It might feel like a bee sting or a cramp... Once your cervix is numb, the doctor needs to dilate it. Again, we're working with your body on things it already knows how to do. The doctor inserts a dilation rod."

She waves a stainless steel rod. It looks disconcertingly like a knitting needle or straightened coat hanger.

"Don't let the length of it scare you. The doctor only inserts the tip of it," she says.

"Once she's got it dilated, (the doctor) is going to insert what's called a vacurette. It's attached to a machine that creates a gentle suction. It's sort of the process when they're cleaning your teeth and they use the suction to clean out the saliva from your mouth. She takes and gently inserts it through your cervix and into your uterus and gently suctions the lining of your uterus. The pregnancy comes out at that time."

Kromenaker says an eight-week fetus, or "gestational sac", looks "like a condom when it first comes out of the package." It's flesh coloured and has little villi or feelers. "If you're less than eight weeks there are no body parts."

The surgical abortion takes longer if the woman is later in the pregnancy because her cervix has to be further dilated to let the fetus pass.

If patients are more than 16 weeks pregnant, they are referred to Minneapolis. They terminate up to 21.6 weeks. There are a handful of doctors in America who perform late-stage abortions.

In Manitoba:

There were 16,746 births in the province between April 1, 2012 and March 31, 2013.

In the same period, 3,918 terminations were performed in Winnipeg.

Women can have an abortion at the Health Sciences Centre and the Women's Health Clinic (WHC). Unlike North Dakota, medication abortions are not performed here.

HSC reports nearly 70 per cent of its patients are from Winnipeg, slightly more than 25 per cent are from elsewhere in the province, 6.3 per cent are from other provinces and 0.8 per cent are from elsewhere.

The cost to an American for an abortion in Winnipeg is $500. They could seek compensation from their insurance provider if the procedure is covered.

Abortions are performed up to 20 weeks in Manitoba. Those beyond 20 weeks are transferred out of province because there is no doctor here who performs those procedures.

There is no restriction in the Criminal Code of Canada to determine how late an abortion can be performed.

History

Updated on Saturday, June 22, 2013 at 12:15 PM CDT: Fixed date.

12:57 PM: Cutlines fixed.

June 24, 2013 at 2:09 PM: Life’s Vision Winnipeg was not formerly known as League for Life Manitoba and its director, Valerie Wadephul, does not speak for Life’s Vision Manitoba. Incorrect information was provided for the print edition version of this story.

You can comment on most stories on winnipegfreepress.com. You can also agree or disagree with other comments.
All you need to do is be a Winnipeg Free Press print or e-edition subscriber to join the conversation and give your feedback.